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Beijing's diagnosis-related group payment reform pilot: Impact on quality of acute myocardial infarction care

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  • Jian, Weiyan
  • Lu, Ming
  • Liu, Guofeng
  • Chan, Kit Yee
  • Poon, Adrienne N.

Abstract

In 2012, China's first diagnosis-related group (DRG) payment system was piloted in Beijing. This study explored whether this payment pilot improved quality and reduced costs of acute myocardial infarction (AMI) care in hospitals implementing DRG payment as compared to control hospitals. A difference-in-difference study design was used with regression and considered several quality indicators including aspirin at arrival, aspirin at discharge, β-blocker at arrival, β-blocker at discharge, statin at discharge, in-hospital mortality, and 30-day readmission rates. DRG payment mechanisms without specific mechanisms to promote care quality did not improve quality of AMI care. Future studies should study the impact of cost control mechanisms together with quality improvement efforts to assess how quality of care may be improved within the Chinese healthcare system. These lessons would be helpful to share with lower-middle-income countries undergoing rapid development that are transitioning to a significantly higher burden of non-communicable diseases.

Suggested Citation

  • Jian, Weiyan & Lu, Ming & Liu, Guofeng & Chan, Kit Yee & Poon, Adrienne N., 2019. "Beijing's diagnosis-related group payment reform pilot: Impact on quality of acute myocardial infarction care," Social Science & Medicine, Elsevier, vol. 243(C).
    • Handle: RePEc:eee:socmed:v:243:y:2019:i:c:s0277953619305854
    DOI: 10.1016/j.socscimed.2019.112590
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    References listed on IDEAS

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    1. Hamada, Hironori & Sekimoto, Miho & Imanaka, Yuichi, 2012. "Effects of the per diem prospective payment system with DRG-like grouping system (DPC/PDPS) on resource usage and healthcare quality in Japan," Health Policy, Elsevier, vol. 107(2), pages 194-201.
    2. Davis, Carolyne K. & Rhodes, Deborah J., 1988. "The impact of DRGs on the cost and quality of health care in the United States," Health Policy, Elsevier, vol. 9(2), pages 117-131, April.
    3. Or., Zeynep, 2014. "Implementation of DRG Payment in France: Issues and recent developments," Health Policy, Elsevier, vol. 117(2), pages 146-150.
    4. Robert C. Rock, 1985. "Assuring Quality of Care Under DRG-Based Prospective Payment," Medical Decision Making, , vol. 5(1), pages 31-34, February.
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    Cited by:

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    3. Lingli Zhang & Lihua Sun, 2022. "Impacts of case‐based payments reform on healthcare providers' behaviour on cataract surgery in a tertiary hospital in China: An eight‐year retrospective study," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(1), pages 504-512, January.
    4. Qian, Mengcen & Zhang, Xinyu & Chen, Yajing & Xu, Su & Ying, Xiaohua, 2021. "The pilot of a new patient classification-based payment system in China: The impact on costs, length of stay and quality," Social Science & Medicine, Elsevier, vol. 289(C).

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